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Thursday, July 2, 2015

The Mpowerment Project’s Guiding Principles

Guiding Principles from theories of behavior change and from
interviews with young bisexual/gay men and service providers
serve as the foundation for the Mpowerment Project.

The Guiding
Principles are key
to the Mpowerment
Project model, and
guide all aspects of
its implementation.
They also help
Projects adapt the
Project in order to
respond to unique
aspects of their
target population
and to differing
levels of funding for
the program.

Young men are very concerned with
social and self-esteem issuesHIV prevention is not in itself particularly motivating or captivating for adult young gay/bisexual men. Agencies that try to reach young gay and bisexual men
often report that it is very difficult to attract the men to their activities. HIV
prevention efforts at an agency cannot be effectively implemented if young men won’t attend. For example, it can be difficult to implement multi-session
groups on HIV prevention. Most young men do not seek out help to change
their sexual behaviors that put them at risk for HIV. It is important to recognize
that HIV/AIDS is only one threat among many that young gay/bisexual men
confront in a homophobic society where gay-bashing, discrimination, and
battles over gay rights are commonplace. Young gay/bisexual men may be
dealing simultaneously with issues of self-esteem, alienation, isolation, cultural/
social identity, racism (in the gay community and in society in general), family
problems, and financial, education, and employment pressures.Therefore, the first Guiding Principle is that a successful HIV
prevention intervention for young gay/bisexual men needs to tie HIV risk-reduction to the satisfaction of other needs, such as
developing friendships, having fun, and enhancing self-esteem.
Through focus groups, it became clear that social concerns—such as how to
meet and have fun with other young gay/bisexual men—are highly motivating.
Thus, a social focus became the central theme of the Project. Using appealing,
fun, engaging social activities and incorporating HIV prevention into them is a
way of ensuring that men will attend and hear about sexual risk reduction and
the importance of HIV testing.

The GMHC Crew, Mpowerment Fairfax VA

Peer influences are strong among
young gay/bisexual MenThe second key issue guiding the development of the Mpowerment Project (MP) is
the recognition that peer influence plays a major role in the lives of young gay/
bisexual men. Numerous studies have shown that—regarding almost any type
of behavior, whether it is smoking, drugs, fashion, political attitudes, or others—
one’s peers are the most credible sources of information, and peer pressure is one of the most highly effective forms of influence. Therefore, the second
Guiding Principle is that for the Mpowerment Project to be effective
in reaching young gay/bisexual men, it needs to be peer-based and
use peer influence.

Mpowerment Training, Newark NJ

Building healthy community among
young gay/bisexual menMany young gay and bisexual men are frustrated with their local gay communities
because there are few places to go to meet other young men and where they can
safely be themselves. Young men often only have a few other gay male friends,
and therefore they can feel lonely and isolated much of the time. Men under
drinking age can typically only find each other online or at a few cruising places,
and men at or over drinking age can also find each other at gay bars—but these
are not health promoting environments.Young men want to be with each other in a relaxed, comfortable environment
where they can be themselves. The MP creates settings where young men can express their identities with each other, find
support, and most importantly, band together to take action on
issues of importance to them. They can feel a part of something
bigger than themselves: a young gay/bisexual men’s community.
Being a part of a young men’s community where men support
each other regarding safer sex and getting tested means that
each young man in the community experiences support from
many others about HIV prevention.Therefore, the third
Guiding Principle is that it is essential to build a young
gay/bisexual men’s community where men support
each other about sexual risk reduction and obtaining
HIV testing, where the social norms and expectations support HIV prevention, and where men help each other in coping
with the stresses of being gay/bisexual.RELATED: Mpowerment Core Elements and Key Characteristics.

Mpowerment Training, Columbus Ohio

Empowerment promotes more lasting
changes in behaviorThe fourth Guiding Principle is that the Project serves a mobilizing
and empowering function within the young gay/bisexual men’s
community—young men take ownership of the Project rather than
having the Project carried out for them. From research in other areas of
behavior change, it is clear that when individuals are actively
involved in finding and implementing solutions to their problems, any changes
they make in their behavior are more likely to last. Thus, providing young gay and bisexual men with a mechanism for analyzing issues and problems that they
experience and coming up with solutions for these problems, and for designing
and running the intervention activities themselves, foster a sense of ownership
of the program and a sense of personal commitment to HIV prevention.The Project focuses on personal empowerment. It helps young men analyze why
they are at risk for HIV and why they do not get tested for HIV as frequently as they should. It also helps them consider what actions they can take to be
healthier and withstand pressures that cause them to be at risk. In addition, the Project focuses on community empowerment: developing a community of
young men that can address some of the stresses and strains that affect them.

Q Flames soccer outreach via The Q Austin, Mpowerment TX

Community-wide change occurs
through interpersonal networksThe program’s design draws from the theory of diffusion of innovations, which states that members of a social system are most likely to adopt new behavioral practices (i.e., safer sex, regular HIV testing) when
they see their peers adopting the behavior and communicating that they feel it is desirable and important. Therefore, the fifth Guiding Principle is
that community change comes about through a process of informal
communication and modeling by peers within their friendship
networks.Increased networks are developed through the community-
building activities of the Project, but men also take the messages about safer sex and testing to men who may never attend any of the Project’s activities. The
Mpowerment Project facilitates a process for young gay/bisexual men to actively
communicate with each other about safer sex and testing, and to encourage each
other to practice these two things through these social networks. The goal is for
safer sex and regular HIV testing to become the mutually accepted norm within
the young gay/bisexual men’s community.

Stuffing condom packets via Mpowerment Long Island, NY

Fostering pride: gay-positive, ethnic/ racial-positive, and sex-positive messages encourage behavior changeThe sixth Guiding Principle of the Mpowerment Project is that the
program enriches and strengthens young gay/bisexual men’s pride
about who they are, and encourages them to explore and celebrate
their sexuality by not just focusing on condom use but by including
a wide variety of safer sex behaviors.Materials produced by the Project
show positive images of young gay/bisexual men that reflect the diversity of
the community. This Guiding Principle—about young gay/bisexual men taking
pride in who they are—encompasses pride in one’s ethnic/racial identity as
well, particularly if they are young men of color. All activities designed to
promote safer sex are fun, uplifting, and sex-positive; fear and shame-inducing
approaches are avoided.

The Evolution Project, Mpowerment Atlanta GA

A “multi-level” HIV prevention program is needed to address a variety of issues and factors that contribute to sexual risk taking and reluctance to get regular HIV testing among young gay/bisexual menSelf-esteem, interpersonal and cultural issues, internalized homophobia,
community norms, and many other factors all influence young men’s risk
behavior. Since young gay/bisexual men engage in unsafe sex for a variety of
reasons, interventions that focus solely on one level of factors will miss men who engage in unsafe sex for other reasons. Not only should the Mpowerment
Project focus on encouraging men to reduce their sexual risk behavior, it should
also encourage men to get tested for HIV regularly. Therefore, the seventh
and final Guiding Principle is the need for a “multi- level” approach.

What prevents young men from engaging in HIV care?

The various components of the Mpowerment Project try to address the variety of
contributors to risk behavior and reluctance to test regularly. For example, Social
Outreach Events and safer-sex Outreach Team performances and outreach
materials change over the course of the intervention so that a wide variety of
issues can be targeted. During our research on the Translating Research into Practice (TRIP-1) Project, we observed that while the success of
the Project was dependent to a significant degree on the effectiveness of staff, the
Implementing Agency and the Project Funder also made major contributions to how well each Project operated.